ED Coding and Reimbursement Alert
Know Difference Between Closed Clavicle Treatments
Question: Encounter notes indicate that a patient suffered from a fracture of their left clavicle. The ED physician was able to treat the fracture without sending the patient to the operating room (OR). However, I’m not sure if the treatment was performed with or without manipulation. Encounter notes indicate that the provider “set clavicle back in place.” Is this manipulation? Illinois Subscriber Answer: Yes, the ED physician did use manipulation for this treatment. On the claim, report 23505 (Closed treatment of clavicular fracture; with manipulation) for the treatment with S42.002A (Fracture of unspecified part of left clavicle, initial encounter for closed fracture) appended to represent the patient’s injury. Also, remember to append modifier LT (Left side) to 23505 to indicate laterality. More on manipulation: The term simply means a nonsurgical procedure where the physician realigns the broken bones, and your physician certainly did that in this case. Another clue that the ED physician used manipulation could be anesthesia, which is usually administered to keep the patient still and minimize pain.
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